View guideline
The Canadian Task Force on Preventive Health Care (CTFPHC) Recommendations on screening for high blood pressure in adults was published in Canadian Family Physician, the official journal of the College of Family Physicians of Canada. The recommendations confirm primary care practitioners can help improve patient outcomes by measuring blood pressure at all appropriate primary care visits and by using the techniques described in the Canadian Hypertension Education Program (CHEP). The new guideline updates prior guidelines developed by the CTFPHC in 1994. The recommendations can be found on this website.

Ottawa, 29 October, 2012–The Canadian Task Force on Preventive Health Care (CTFPHC) today provided recommendations to Canadian clinicians and policymakers on screening for hypertension in adults aged 18 years and older. The guideline, developed by the CTFPHC, an independent body of specialists with expertise in primary care and prevention, confirms primary care practitioners can help improve patient outcomes by measuring blood pressure at all appropriate primary care visits and by using the techniques described in the Canadian Hypertension Education Program (CHEP). This new guideline updates prior guidelines developed by the CTFPHC in 1994.

“Despite improvements over the last two decades, roughly 40 percent of Canadian adults are affected by high or high-normal blood pressure,” said Dr. Richard Birtwhistle, Vice-Chair of the Canadian Task Force on Preventive Health Care and Professor in the Department of Family Medicine and Community Health and Epidemiology and Director of the Centre for Studies in Primary Care at Queen’s University in Kingston, Ontario. “Blood pressure measurement is inexpensive and if done regularly, can help detect hypertension and lead to a reduction of serious cardiovascular patient outcomes and avoid significant long-term costs for Canadians.”

Since 1984 the CTFPHC has recommended blood pressure measurement during regular physician visits. This recommendation is re-affirmed with the current guidelines, which in turn are consistent with recommendations from CHEP and the U.S. Preventive Services Task Force (USPSTF) and endorsed by both the Canadian Stroke Network and the College of Family Physicians of Canada.

The CTFPHC found no evidence to support a specific screening interval, but suggests that blood pressure be measured at all appropriate patient visits and supports the CHEP recommendation that Canadians with high-normal blood pressure should have their blood pressure reassessed annually. The CTFPHC acknowledges that the frequency and timing of blood pressure screening may vary between patients, and that the risk of high blood pressure, stroke or heart disease changes over a person’s natural lifespan. Age, comorbidities and the presence of other risk factors may influence screening frequency.

While no specific screening frequency is identified, Guideline authors note, “Practitioners should remain alert for opportunities to screen those who infrequently attend their practice and others who have not been screened recently. These patients are often younger, appear healthy and may not have risk factors for hypertension or cardiovascular disease and may be overlooked for screening opportunities.”

For adults aged 18 years and older without previously diagnosed hypertension, the CTFPHC recommends:

Blood pressure measurement at all appropriate primary care visits.

Blood pressure be measured according to the current techniques described in the Canadian Hypertension Education Program (CHEP) recommendations for office and out-of-office blood pressure measurement.

For people who are found to have an elevated blood pressure during screening, the CHEP criteria for assessment and diagnosis of hypertension should be applied to determine whether the patient meets diagnostic criteria for hypertension.

The Canadian Task Force on Preventive Health Care has been established to develop clinical practice guidelines that support primary care providers in delivering preventive health care. The mandate of the Task Force is to develop and disseminate clinical practice guidelines for primary and preventive care, based on systematic analysis of scientific evidence.

Before each meeting, every member of the Canadian Task Force on Preventive Health Care (CTFPHC) and of the Evidence Review and Synthesis Centre (ERSC) completes a Declaration of Affiliations and Interests Form to report any potential conflicts of interest (e.g., financial, business or professional, intellectual). Disclosure is required for each new topic, and disclosures must be updated to reflect any changes that have occurred since an initial disclosure. Completed forms are kept on file, and outside experts who are asked to comment on the recommendations and documents prepared by the CTFPHC are also required to complete disclosure forms, which are kept on file. For more information, please refer to the CTFPHC’s Procedure Manual.